体外循环下治疗布-加综合征合并下腔静脉血栓形成

目的总结在体外循环辅助下,经右房切口治疗合并下腔静脉血栓形成的布-加氏综合征的治疗经验。方法回顾我院自2002年9月至2010年7月共计49例在体外循环辅助下．经右心房切口治疗合并下腔静脉血栓的布加氏综合征的临床病例和随访资料。结果全组病人均成功的在体外循环辅助下完成经右房切口下腔静脉狭窄段扩张及血栓取出术。术中在手指破膜后再使用3．0×4．0cm球囊进行扩张。围手术期病人无死亡,无急性肺检塞等严重并发症的发生。术后随访0^-36个月,所有病人术后症状明显缓解,腹水及下肢水肿减轻至消失。1例病人术后1年后出现再狭窄,经股静脉行下腔静脉球囊扩张后好转。全组病人术后随访未见有血栓形成。结论在体外循环下,经右房切口对于合并下腔静脉血栓的布-加氏综合征是一种安全有效的治疗方法．     

先天性心脏病合并感染性心内膜炎30例诊治分析

目的:探讨先天性心脏病合并感染性心内膜炎的诊断及治疗。方法:回顾性分析30例先天性心脏病合并感染性心内膜炎患者的临床特点、手术时机、手术方法及疗效。结果:本组治愈率90%,病死率10%;术前1例死于脑栓塞,术后早期死亡2例分别死于心力衰竭和脑出血;术后随访3个月~5 a,心功能恢复良好。结论:先天性心脏病不明原因发热>1周应考虑感染性心内膜炎;掌握手术时机,选择合适术式,结合围手术期抗感染治疗可提高治愈率。     

根管锥度和根管固位材料对牙体组织应力分布影响的三维有限元分析

目的 观察3种锥度根管采用不同根管桩修复对牙体组织应力分布的影响,以期为临床合理选用根管桩提供实验依据.方法 分别建立35号K锉、ProTaper和Profile器械根管预备后的下颌第一磨牙三维有限元模型,并分别模拟纤维树脂桩、不锈钢根管桩和银汞合金桩根管固位修复.运用Marc有限元软件,采用中央垂直加载,分析3种不同根管桩修复时牙颈部和牙根部应力分布的状况.结果 不同根管锥度对3种根管固位方式下的应力分布趋势无明显影响.不锈钢根管桩应力集中部位主要位于远中牙根中上部,远中根管口最高Von-Mises应力约为45 Mpa;银汞桩应力集中部分主要位于远中根管口上端及髓腔内,远中根管口最高Von-Mises应力约为16 Mpa;纤维树脂桩应力分布较均匀,未见明显应力集中.结论 纤维桩是比较理想的根管固位形式,应力分布接近于无根管桩状态;不锈钢根管桩在根中部容易形成高应力集中,增加根折发生率.

Abstract：

Objective To evaluate the effect of root canal taper and post on tooth stress distribution. Methods Three-dimensional finite element models of human mandibular first molar with root canals prepared with 35# K file, ProTaper and Profile were established. The tooth were restored with fiberresin, stainless steel and silver amalgam posts respectively. A vertical load on tooth occlusal surface was simulated. Marc software was used to analyze and calculate the stress distributions in the tooth restored with three kinds of different root canal posts, especially the in the cervical part and root. Results Different tapered root canals had no obvious influence on stress distribution in all three different posts. Stress distribution of stainless steel post located at the cervical and middle part of distal root, the highest Von-Mises stress was about 45 MPa. Stress distribution of silver amalgam post located at the orifice of root canal and pulp fundus, the highest Von-Mises stress was about 16 MPa. Stress distribution of fiber-resin post had no obvious stress concentration. Conclusions Fiber-resin post is the most ideal root canal post. Stainless steel post causes remarkable stress concentration in the root, which may raise the possibility of root fracture.     

含血Plegisol液持续微流量灌注对猪离体供心水肿的影响

目的:观察含血Plegisol液持续微流量灌注对猪离体供心水肿的影响,探讨心脏移植中保护供心的有效方法。方法:28只瑞典家猪,随机分为实验组和对照组,每组14只,每组随机选7只为供体,7只为受体。实验组离体猪心在热缺血10min,4℃含血保护液持续微流量灌注10h后行原位心脏移植,对照组离体猪心在热缺血10min,低温静置10h后行原位心脏移植。主动脉开放24h后取心肌组织行组织学检查,记录24h冠状动脉平均血流量,计算心肌含水量。结果:组织学检查显示对照组冠脉内皮及心肌组织水肿程度比实验组严重;实验组冠状动脉平均血流量高于对照组,心肌含水量低于对照组(t=6.058和18.066,P<0.001)。结论:含血Plegisol液持续微流量灌注可显著减轻离体猪心冠脉内皮及心肌的水肿程度。     

Cannabidiolic acid prevents vomiting in Suncus murinus and nausea-induced behaviour in rats by enhancing 5-HT1A receptor activation

Background and Purpose

To evaluate the ability of cannabidiolic acid (CBDA) to reduce nausea and vomiting and enhance 5-HT_1A receptor activation in animal models.

Experimental Approach

We investigated the effect of CBDA on (i) lithium chloride (LiCl)-induced conditioned gaping to a flavour (nausea-induced behaviour) or a context (model of anticipatory nausea) in rats; (ii) saccharin palatability in rats; (iii) motion-, LiCl- or cisplatin-induced vomiting in house musk shrews (Suncus murinus); and (iv) rat brainstem 5-HT_1A receptor activation by 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) and mouse whole brain CB₁ receptor activation by CP55940, using [³⁵S]GTPγS-binding assays.

Key Results

In shrews, CBDA (0.1 and/or 0.5 mg·kg⁻¹ i.p.) reduced toxin- and motion-induced vomiting, and increased the onset latency of the first motion-induced emetic episode. In rats, CBDA (0.01 and 0.1 mg·kg⁻¹ i.p.) suppressed LiCl- and context-induced conditioned gaping, effects that were blocked by the 5-HT_1A receptor antagonist, WAY100635 (0.1 mg·kg⁻¹ i.p.), and, at 0.01 mg·kg⁻¹ i.p., enhanced saccharin palatability. CBDA-induced suppression of LiCl-induced conditioned gaping was unaffected by the CB₁ receptor antagonist, SR141716A (1 mg·kg⁻¹ i.p.). In vitro, CBDA (0.1–100 nM) increased the E_max of 8-OH-DPAT.

Conclusions and Implications

Compared with cannabidiol, CBDA displays significantly greater potency at inhibiting vomiting in shrews and nausea in rats, and at enhancing 5-HT_1A receptor activation, an action that accounts for its ability to attenuate conditioned gaping in rats. Consequently, CBDA shows promise as a treatment for nausea and vomiting, including anticipatory nausea for which no specific therapy is currently available.     

攻毒扶正法对非酒精性脂肪性肝炎大鼠肝组织内Th1/Th2类细胞因子的影响

目的:观察攻毒扶正法对非酒精性脂肪性肝炎(NASH)大鼠Th1/Th2类细胞因子免疫反应的影响。方法:用高脂饲料与四氯化碳(CCl4)制备NASH大鼠模型,分别用乙肝清热解毒颗粒、乙肝养阴活血颗粒、辛伐他丁溶液进行灌胃,用药4周后取材。ELISA法测定肝组织TNF-α、IFN-γ、IL-4、IL-6含量。结果:与正常组相比,模型组肝组织中TNF-α、IL-4、IL-6含量增高,IFN-γ含量降低,差异有统计学意义(P<0.01)。各治疗组对TNF-α、IL-4、IL-6有负向调节作用,可使其含量降低,对IFN-γ有正向调节作用,并能整体调节Th1/Th2的紊乱状态。结论:在NASH大鼠体内Th1/Th2类细胞因子网络紊乱,攻毒扶正法可对其进行调节。     

Factors influencing the diagnostic accuracy and management in acute surgical patients

AIM:To evaluate the diagnostic accuracy(DA) in acute surgical patients admitted to a District General Hospital.METHODS: The case notes of all acute surgical patients admitted under the surgical team for a period of two weeks were reviewed for the data pertaining to the admission diagnoses, relevant investigations and final diagnoses confirmed by either surgery or various other diagnostic modalities. The diagnostic pathway was recorded from the source of referral [general practitioner(GP), A and E, in-patient] to the correct final diagnosis by the surgical team. RESULTS: Forty-one patients(23 males) with acute surgical admissions during two weeks of study period were evaluated. The mean age of study group was 61.05 ± 23.24 years. There were 111 patient-doctor encounters. Final correct diagnosis was achieved in 85.4% patients. The DA was 46%, 44%, 50%, 33%,61%, 61%, and 75% by GP, A and E, in-patient referral, surgical foundation year-1, surgical senior house officer(SHO), surgical registrar, and surgical consultant respectively. The percentage of clinical consensus diagnosis was 12%. Surgery was performed in 48.8% of patients. Sixty-seven percent of GP-referred patients, 31% of A and E-referred, and 25% of the in-patient referrals underwent surgery. Surgical SHO made the most contributions to the primary diagnostic pathway.CONCLUSION: Approximately 85% of acute surgical patients can be diagnosed accurately along the diagnostic pathway. Patients referred by a GP are more likely to require surgery as compared to other referral sources. Surgical consultant was more likely to make correct surgical diagnosis, however it is the surgical SHO that contributes the most correct diagnoses along the diagnostic pathway.     

化痰与活血方对非酒精性脂肪肝氧应激的影响

目的:观察化痰方与活血方对非酒精性脂肪肝(NAFLD)大鼠氧应激损伤的影响,探讨两方在NAFLD治疗中的作用。方法:制备NAFLD大鼠模型,同时用化痰方和活血方对模型进行干预,并与西药组(二甲双胍+罗格列酮)进行对照,设置正常组、模型组、西药组、化痰方组、活血方组及合方组共6组,检测肝组织CYP450及CYP2E1活性,测定SOD、MDA。结果:模型组的CYP450和CYP2E1活性增强(P<0.05),SOD活性下降(P<0.05),MDA含量升高(P<0.01);所有中药组均能降低CYP2E1活性(P<0.05),而西药组能降低CYP450活性(P<0.05);化痰方与活血方能够提高SOD活性(P<0.01),降低MDA含量。结论:NAFLD大鼠存在明显的氧应激和脂质过氧化损伤情况,化痰方与活血方均能不同程度地调节NAFLD大鼠的氧应激水平,改善脂质过氧化,对NAFLD具有确切的防治作用。     

青岛市1300名吸毒者HIV和梅毒螺旋体感染状况及相关因素分析

目的调查吸毒人群HIV和梅毒螺旋体感染的状况,并探讨引起感染的相关因素。方法回顾性分析1300名新进看守所的吸毒人员的人口学资料和行为学资料,检测其HIV、梅毒螺旋体感染情况,分析其病原体感染现状,归纳总结出感染的相关因素。结果吸毒人群中HIV、梅毒螺旋体感染发生率远较正常人群高(P<0.05),吸毒人群中共用针具者、危险性行为者上述病原体感染率均较无上述危险因素的同质人群为高(P<0.05,OR>3)。结论吸毒者人群中HIV、梅毒螺旋体感染发生率远较正常人群高,共用针具、危险性行为有可能是其感染高发的原因。